Many child care operators are moving away from bleach as their primary disinfectant and sanitizer because it has been recognized as an asthmagen, meaning a substance that can cause new asthma. Asthma is a chronic disease that has been progressively affecting a greater proportion of the US population over the past two decades without a single source of causation.

The 2013 Update is a how-to guide for converting a single site to a bleach-free environment, replicating this intervention on a larger scale, and assuring that a child care site is prepared for communicable disease outbreaks. You may also access this report and associated program implementation resources from the website of RAMP, Regional Asthma Management and Prevention www.rampasthma.org

In a 2008 pilot project to study this issue, the San Francisco Asthma Task Force found that in a single day, one child care worker could potentially spray bleach up to almost 100 times if cleaning is her/his designated duty for the day. Child care workers have reported that spraying bleach frequently throughout the day has caused respiratory distress, allergic reactions, and burns to skin/ clothing.

Funding was provided by Human Services Agency of San Francisco, San Francisco Department of Children, Youth & Their Families, First 5 San Francisco Children & Families Commission, San Francisco Department of Public Health, Regional Asthma Management and Prevention, San Francisco Public Health Foundation, San Francisco Department of the Environment, Neil Gendel, Director of Healthy Children Organizing Project, and the San Francisco Foundation.